Ｄｉａｇｎｏｓｔｉｃ ｖａｌｕｅ ｏｆ ｐｌａｓｍａ ＹＫＬ⁃４０， ＣＲＰ， ＩＬ⁃６ ｉｎ ａｃｕｔｅ ｃｏｒｏｎａｒｙ ａｒｔｅｒｙ ｉｎｊｕｒｙ ｉｎ ｃｈｉｌｄｒｅｎ ｗｉｔｈ Ｋａｗａｓａｋｉ ｄｉｓｅａｓｅ
Ｍｉｎ Ｌｉ， Ｙｕａｎ Ｓｈｉｊｉａｎ， Ｌｉｕ Ｙａｈｏｎｇ， Ｗａｎｇ Ｊｉｎ， Ｎｉｕ Ｓｈａｏｍｉｎ， Ｙａｎｇ Ｙｉｎａｎ， Ｄｏｎｇ Ｘｉａｎｇｙｕ． Ｄｅｐａｒｔｍｅｎｔ ｏｆ Ｐｅｄｉａｔｒｉｃｓ， Ｌａｎｚｈｏｕ
Ｕｎｉｖｅｒｓｉｔｙ Ｓｅｃｏｎｄ Ｈｏｓｐｉｔａｌ， Ｇａｎｓｕ Ｐｒｏｖｉｎｃｅ， Ｌａｎｚｈｏｕ ７３００３０，Ｃｈｉｎａ
Ｃｏｒｒｅｓｐｏｎｄｉｎｇ ａｕｔｈｏｒ： Ｄｏｎｇ Ｘｉａｎｇｙｕ， Ｅ⁃ｍａｉｌ： ｄｘｙ０２２３＠ １６３． ｃｏｍ
Ｆｕｎｄｉｎｇ ｐｒｏｇｒａｍ： Ｎａｔｕｒａｌ Ｓｃｉｅｎｃｅ Ｆｏｕｎｄａｔｉｏｎ ｏｆ Ｇａｎｓｕ Ｐｒｏｖｉｎｃｅ （１７ＪＲ５ＲＡ２２２）

Abstract：

Objective To analyze the diagnostic value of plasma human cartilage glycoprotein 39(YKL-40), C-reactive protein(CRP), and interleukin-6(IL-6) in coronary artery injury(CAL) in children with Kawasaki disease(KD). Methods 125 children with KD admitted to the Department of Pediatrics of Lanzhou University Second Hospital from April 1, 2018 to December 31, 2021 were selected as the KD group. They were further divided into the CAL subgroup of 53 cases and the NCAL subgroup of 72 cases based on whether they were combined with CAL. In addition, 125 healthy children who were matched in gender and age during the same period were selected as the healthy control(HC) group and 125 children with fever due to digestive tract infection as the fever control(FC) group. Collect clinical data of each group, and detect the plasma levels of YKL-40, CRP, and IL-6 in all tested children. Multivariate logistic regression analysis was used to analyze the risk factors for the occurrence of CAL in children with KD. The value of plasma YKL-40, CRP, and IL-6 in the diagnosis of CAL in children with KD was analyzed by subject performance characteristic curve(ROC).Results Comparison of plasma levels of YKL-40, CRP, and IL-6 showed that KD group>FC group>HC group(F/P=296.352/<0.001, 35.162/<0.001, 20.266/<0.001). The plasma levels of YKL-40, CRP, and IL-6 in the CAL subgroup were higher than those in the NCAL subgroup(t/P=7.434/<0.001, 7.967/<0.001, 7.444/<0.001); The proportion of pretreatment thermal duration, IVIG non response, and IVIG start time ≥ 10 days in CAL subgroup was higher than that in NCAL subgroup(χ²/P=6.831/<0.001,8.304/0.004,3.953/0.047).Multivariate logistic regression analysis showed that non response to IVIG, high YKL-40, high CRP, and high IL-6 were risk factors for developing CAL in children with KD [OR(95%CI)=4.627(2.072 to 10.336), 1.441(1.128 to 1.840), 1.540(1.106 to 2.145), and 1.343(1.098 to 1.644)]. The ROC curve analysis showed that the area under the curve of plasma YKL-40, CRP, IL-6, and their combination in the diagnosis of CAL in children with KD was 0.813, 0.846, 0.821, and 0.923. The combined diagnostic efficacy of the three indicators was higher than that of the single indicator diagnosis(Z/P=2.965/0.012, 2.536/0.020, 2.308/0.025). Conclusion The average increase in plasma YKL-40, CRP, and IL-6 levels in children with KD is related to the occurrence of CAL in children with KD. Combining the three indicators has high value in the diagnosis of CAL in children with KD.

Kawasaki disease;                    Acute coronary artery injury;                    Human cartilage glycoprotein-39;                    C-reactive protein;                    Interleukin-6;                    Diagnosis;